6 healthcare reactions to Trump's budget proposal

President Donald Trump this week released his fiscal year 2019 budget proposal, which includes various healthcare measures.

Here are six reactions to the proposal from healthcare groups.

1. The American Hospital Association's reaction was mixed. "Unfortunately, this budget proposal would weaken the important safety net that Medicaid offers for millions of Americans who rely on the program for their healthcare needs. Access to care for vulnerable, low-income people including the elderly, disabled, children and veterans could be jeopardized by making large reductions in the program," AHA President and CEO Rick Pollack said in a statement.

"We are encouraged by the Administration's willingness to tackle skyrocketing drug costs — a heavy burden borne by America's hospitals and the patients we serve. However, we are opposed to the administration's continued overreach regarding their authority over the 340B Drug Pricing Program … We encourage the administration to adopt many of the proposals we have offered to lower drug costs."

2. The Federation of American Hospitals reacted negatively to the proposal. "According to MedPAC [the Medicare Payment Advisory Commission], hospitals are already experiencing the lowest Medicare margins in history, while the CBO [Congressional Budget Office] says nearly half of all hospitals will be facing negative margins by 2025," Federation of American Hospitals President and CEO Chip Kahn said in a statement.

"The White House's FY19 budget proposal would more than double the $160+ billion in cuts imposed on hospitals since 2010.

"Among the flawed proposals are massive reductions in Medicare bad debt payments and cutbacks in funding for hospital care for millions of uninsured Americans, plus those in post-acute facilities. It also dramatically reduces resources for Medicaid and the training of needed new doctors.

"Enough is enough. These unsustainable cuts would directly impact hospitals' ability to serve patients."

3. 340B Health, an association with more than 1,300 hospital members, also expressed concerns. "The President's proposal to alter Medicare payment policies for hospitals participating in … 340B … raises serious concerns about the future of this vital program and the patient care it supports," the group said in a statement. "In the guise of lowering drug prices, the administration is seeking to continue its misguided policy of reducing Part B payments to 340B hospitals, a policy that violates Medicare law and undermines the 340B program enacted by Congress. This policy is already forcing many hospitals to cut back on services and personnel and has weakened their ability to serve low-income and rural patients.

"The administration has proposed to take money away from hospitals that serve high volumes of low-income and rural patients, harming access to care for Americans who are underinsured and enrolled in Medicaid and Medicare. This policy would not lower drug prices and could, in fact, lead to higher profits for drug manufacturers. Congress should reject this ill-advised proposal and continue its strong, bipartisan support for this vital program."

4. The Association of American Medical Colleges argued the proposal would "exacerbate the projected physician shortage," and that the 340B program proposal "does nothing to address this problem and is counter to the intent of the program." "The administration's proposed cuts would be devastating to patients, current and future providers, the healthcare safety net and, ultimately, our nation's health security," Association of American Medical Colleges President and CEO Darrell Kirch, MD, said in a statement. "The AAMC and the nation's medical schools and teaching hospitals urge Congress to reject the proposals harmful to programs that are vital to the health of the nation."

5. The National Association of County and City Health Officials, which represents nearly 3,000 local governmental health departments, noted the effects on the CDC. "The disinvestment in public health programs will only cost this nation more in the end," Laura Hanen, NACCHO's interim executive director and chief of government affairs, said in a emailed statement. "The budget makes deep cuts that will negatively impact CDC and state and local health department's ability to do their job — which is to keep our communities healthy and safe."

6. America's Essential Hospitals applauded efforts to curb opioid addiction and veterans care funding, but called the budget plan overall "unacceptable." "We have serious concerns about proposals for the 340B Drug Pricing Program that appear to restrict program participation and impose administratively burdensome new reporting requirements," Bruce Siegel, MD, president and CEO of America's Essential Hospitals, said in a statement. "The threat to the healthcare safety net is worsened by the proposal to expand cuts to hospital outpatient departments and large-scale reductions in graduate medical education spending. We urge the administration and Congress to protect funding for hospitals that care for those who face financial hardships and that deliver trauma care, emergency preparedness, healthcare workforce training and other communitywide services. We commit to working with policymakers to ensure all patients and communities have access to the vital services they need."


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